Shah and Milano listed conditions for weaning a ventricular assist device (VAD) placed in a patient for acute heart failure. The authors are from Duke University in Durham, North Carolina.
Parameters:
(1) heart rate
(2) mean arterial pressure
(3) left ventricular ejection fraction
(4) cardiac index on transesophageal echocardiography
(5) ventricular filling pressure on Swan-Ganz catheter measurements
(6) VO2 max on exercise testing
|
Parameter |
Finding |
Points |
|
heart rate |
>= 100 beats per minute |
0 |
|
|
< 100 beats per minute |
1 |
|
mean arterial pressure |
<= 70 mm Hg |
0 |
|
|
> 70 mm Hg |
1 |
|
left ventricular ejection fraction |
<= 40% |
0 |
|
|
> 40% |
1 |
|
cardiac index |
<= 2.2 L per min per sq meter |
0 |
|
|
> 2.2 L per min per sq meter |
1 |
|
ventricular filling pressure |
>= 15 mm Hg |
0 |
|
|
< 15 mm Hg |
1 |
|
VO2 max |
<= 15 mL per min per kg |
0 |
|
|
> 15 mL per min per kg |
1 |
number of ideal conditions present =
= SUM(points for all 6 parameters)
Interpretation:
• minimum number: 0
• maximum number: 6
• The greater the number of conditions met the better the chances of successful weaning.
Purpose: To evaluate a patient with a ventricular assist device (VAD) placed for heart failure for weaning conditions based on the criteria of Shah and Milano.
Specialty: Critical Care, Emergency Medicine, Cardiology
Objective: selection
ICD-10: I50.9,
